Page 1385 - Small Animal Internal Medicine, 6th Edition

CHAPTER 82 Anemia 1357

TABLE 82.6
VetBooks.ir Practical Use of Blood Components PRBCs STORED PLASMA FFP CRYO CRYOPOOR

WHOLE BLOOD

Hypovolemic anemia +++ ++ − − − −
Isovolemic anemia + +++ − − − −
vWD − − − +++ ++++ −
Hemophilia A − − − +++ ++++ −
Hemophilia B − − +++ ++ − ++++
Rodenticide toxicity − − +++ ++ − ++++
Hypoalbuminemia − − ++ + − ++++
Liver disease − − ++++ ++ − ++++
Pancreatitis − − ++++ +++ − ++++
AT deficiency − − ++++ +++ − ++++
DIC ++ + ++ ++++ − ++

AT, Antithrombin; Cryo, cryoprecipitate; Cryopoor, cryopoor plasma; DIC, disseminated intravascular coagulation; FFP, fresh-frozen plasma;
PRBCs, packed red blood cells; vWD, von Willebrand disease.
− to ++++, Least indicated to best indicated.

report, 17% of dogs that had never received a transfusion guarantee complete compatibility. Major and minor cross-
were found to be incompatible by cross-matching (Odunayo match kits are now commercially available for both dogs and
et al., 2017). In addition, studies have reported a lack of cats (http://www.rapidvet.com/xmatch_info.html); this kit
association between pregnancy and the development of anti- has recently been validated (ADD REFS PENDING). Blood
bodies in dogs (Blais et al., 2009). Transfusion reactions can compatible on cross-matching results in significantly higher
occur if blood positive for DEA 1.1, 1.2, or 7 is transfused, post-transfusion HCTs in the recipient (Weltman et al.,
so donors should be negative for those antigens. However, 2014).
clinically relevant acute hemolytic transfusion reactions Rapid, cage-side blood-typing cards for DEA 1.1 in dogs
are extremely rare in dogs. Transfusion of blood from a and for groups A and B in cats (RapidVet-H, DMS Labora-
donor who has not been typed and has never been trans- tories, Flemington, NJ) and a gel-based system (DME VET
fused to a recipient, independently of their blood type, is Quick-Test DEA 1.1 and A+B, Alvedia, Limonest, France)
generally safe. have been validated and are now commercially available.
Blood groups in cats include A, B, AB, and Mik. Cats Interestingly, in some countries transfusing blood from
tested in the United States have almost exclusively been type dogs into cats appears to be a common emergency practice.
A; the prevalence of type B cats varies greatly from geo- However, the presence of strong antibodies against cat
graphic region to region and among breeds. Breeds in which erythrocytes was recently demonstrated in dogs (Priolo
15% to 30% of the cats are type B include Abyssinian, Birman, et al., 2017); this procedure is strongly discouraged.
Himalayan, Persian, Scottish Fold, and Somali; breeds in
which more than 30% of cats are type B include the British BLOOD ADMINISTRATION
Shorthair and Devon Rex. Because fatal transfusion reac- Refrigerated blood may be warmed before or during admin-
tions commonly occur in type B cats receiving type A blood, istration, particularly in small dogs or cats; excessive heat
cats should always be cross-matched or typed before receiv- should be avoided, however, because fibrinogen precipita-
ing a transfusion. In those cases, a type B cat should be used tion or autoagglutination may occur. However, warming up
as a donor. Most type B cats seen in our clinic in the past 10 the blood before transfusion appears to have no effect on the
years have been domestic short-haired cats. Blood typing is recipient’s core temperature, so it may not be necessary. The
also vital in cattery situations to prevent neonatal isoeryth- administration set should have a blood transfusion filter in
rolysis in type A or AB kittens born to type B queens. place to remove clots and other particulate matter, such as
platelet aggregates. The blood is usually administered via the
CROSS-MATCHING AND BLOOD TYPING cephalic, saphenous, or jugular veins. However, intraosse-
Cross-matching is an alternative to blood typing in in-house ous infusion may be performed in small animals, neonates,
donors or animals that have had prior transfusions, in cats, or animals with poor peripheral circulation. To administer
or in animals that will require multiple transfusions. Cross- fluids or blood intraosseously, the skin over the femur is sur-
matching detects many incompatibilities but does not gically prepared, and the skin and periosteum of the femoral